Breast & nipple thrush

Breast and nipple thrush can cause strong nipple and breast pain. The pain may be severe enough to lead to early weaning if the condition is not treated.

Thrush is a fungal infection caused by the organism Candida albicans, which can occur in the nipples or breast tissue (as well as other places in the body). 

If you have nipple pain that doesn’t go away when you adjust your breastfeeding attachment, you may need to talk with a lactation consultant or other health care professional. Early diagnosis and treatment of nipple and breast thrush will help to improve your breastfeeding experience.

Causes

Breast and nipple thrush may be linked to a history of vaginal thrush, recent use of antibiotics or nipple damage. However, sometimes the cause is not known. 

Symptoms

The most common symptom is nipple pain or breast pain, or both.

Nipple thrush pain is often described as burning, itching, or stinging and may be mild to severe. The pain is usually ongoing and doesn’t go away with improved positioning and attachment of your baby to the breast. Your nipples may be tender to touch and even light clothing can cause pain.

Breast thrush pain can vary. It has been described as a stabbing or shooting pain, a deep ache or a burning sensation that radiates through the breast. It may be in one or both breasts.

Often this pain is experienced immediately after, as well as in between, feeds.

Signs of nipple and breast thrush

There are usually no obvious signs of thrush on your nipples. However some signs may be present and include:

• your nipples may appear bright pink; the areola may be reddened, dry or flaky. Rarely a fine white rash may be seen
• nipple damage (e.g. a crack) that is slow to heal
• signs of thrush may be present in your baby's mouth or on your baby's bottom, or both. Thrush in the mouth appears as a thick white coating on the tongue or white spots on the inside of the cheeks, or both. Thrush on a baby's bottom appears as a bright red rash with spots around it which does not clear without antifungal cream.

If you or your baby have been diagnosed with thrush you will be both need to be treated.

Management and treatment

Breast or nipple thrush is treated with antifungal tablets and creams. You also need to treat thrush in your baby and any other fungal infection in you or your family members.

• Thrush in your baby’s mouth is treated using an oral gel or drops.
• Breast and nipple thrush is treated with antifungal medicine and antifungal nipple gel/creams.
• Treat any other site of fungal infection in the whole family, i.e. vagina, nappy rash, feet.
• Keep your nipples dry by frequently changing breast pads as thrush grows well in a moist and warm environment.
• Clean teats and dummies thoroughly after use and boil for five minutes. Replace weekly if possible.
• To prevent the spread of thrush, wash your hands thoroughly after nappy changes and before and after applying any creams/lotions.
• Wash towels, bras, cloth nursing pads etc. in hot soapy water and air dry outside.

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